肝纤维化是多种慢性肝病进展中的核心病理环节，其进展直接关乎患者预后，目前临床尚无特效手段实现完全逆转，因此探索有效治疗策略迫在眉睫。过氧化物酶体增殖物激活受体（PPAR）作为一类配体激活的核转录因子家族核心成员，在调控肝星状细胞（HSCs）活化、炎症反应、脂质代谢及氧化应激等肝纤维化关键病理过程中发挥不可或缺的调控作用，近年来已成为肝纤维化治疗领域极具潜力的靶点。中医药以多成分、多靶点、多途径及整体调节的独特优势在肝纤维化防治中占据重要地位，研究证实，无论是生物碱类、黄酮类、酚类等中药活性成分，还是具有益气活血、清热凉血等功效的中药复方，均能通过调控PPAR信号通路干预肝纤维化的多重病理环节，其作用机制具体涵盖抑制HSCs活化及异常自噬、减轻肝脏炎症浸润、调节脂质代谢紊乱、抑制氧化应激损伤，以及缓解衰老相关的代谢失衡与炎症加剧等方面。系统梳理中医药调控PPAR信号通路干预肝纤维化的研究进展，深入剖析其作用机制，以期为肝纤维化的临床治疗优化及相关新药研发提供科学思路与实验依据。

Hepatic fibrosis（HF） is a core pathological link in the progression of various chronic liver diseases, and its development directly affects the prognosis of patients. Currently, there are no specific clinical methods to completely reverse it, making the exploration of effective treatment strategies an urgent task. Peroxisome proliferator-activated receptors（PPARs）, as key members of a family of ligand-activated nuclear transcription factors, play an indispensable regulatory role in the key pathological processes of HF, such as the activation of hepatic stellate cells（HSCs）, inflammatory responses, lipid metabolism, and oxidative stress. In recent years, they have become a highly promising target in the field of HF treatment. Traditional Chinese medicine（TCM）, with its unique advantages of multi-component, multi-target, multi-pathway, and holistic regulation, holds an important position in the prevention and treatment of HF. The research has confirmed that both active components of TCM such as alkaloids, flavonoids, and phenols, and TCM compound prescriptions guided by functions like invigorating qi and promoting blood circulation, clearing heat and cooling blood, can intervene in multiple pathological links of HF by regulating the PPAR signaling pathway. The specific mechanisms of action include inhibiting the activation and abnormal autophagy of HSCs, reducing liver inflammatory infiltration, regulating lipid metabolism disorders, inhibiting oxidative stress damage, and alleviating age-related metabolic imbalances and inflammatory exacerbation. A systematic review of the research progress on the regulation of the PPAR signaling pathway by TCM in the intervention of HF and an in-depth analysis of its mechanisms of action are expected to provide scientific ideas and experimental evidence for the optimization of clinical treatment of HF and the development of related new drugs.

R285.5

国家自然科学基金资助项目(82305074); 全国名中医传承工作室建设项目(国中医药办人教函[2018]119); 河南省中医药科研专项课题(2025ZY1013)